Colistin IV

Dosing: Adult Antimicrobial Dosing, Non-dialysis

Indication Dosing
All IV Indications 5 mg/kg IV x1 loading dose, then contact ID pharmacy for maintenance dose recommendations

Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis

Indication

Intermittent Hemodialysis

Continuous Hemodialysis
All IV Indications 5 mg/kg IV x1 loading dose, then contact ID pharmacy for dosing recommendations

Dialysis Notes

Intermittent HD assumes high-flux hemodialysis. CRRT assumes CVVHD with ultrafiltration rate 2L/h and residual native GFR < 10 mL/min.  For detailed view of dialysis dosing and evidence, see Dosing in Hemodialysis document.

Dosing for inhaled colistin per primary team protocols

Other more effective, less-toxic agents are available for most serious Gram-negative rod infections.  In cases where an IV polymyxin is necessary, polymyxin B should be used preferentially for non-urinary tract infections in adults.

All use of IV colistin requires authorization from the Antimicrobial Stewardship Program or consulting ID fellow.  Inhaled use of colistin is allowed for unrestricted use in prophylaxis in lung transplant.

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